Poster #7 - Parent concerns, intervention access, and developmental needs in high-risk NICU graduates

• In Event: Poster Session 04

Abstract

Background: Infants who experience an extended Neonatal Intensive Care Unit (NICU) hospitalization are at increased risk for autism, developmental delays, and other neurodevelopmental challenges (Hollanders et al., 2019). There is limited longitudinal information, however, about the early emergence of developmental needs in infants with early medical risk over the first years of life. Our study is broadly focused on following infants who qualified for the California High-Risk Infant Follow-up (HRIF) Program following extended stays in the NICU from 6 to 24 months of age, to learn more about social, brain, and general development over this critical period. Here, we present preliminary data from the 6-month study visit.

Objectives: To better understand the needs of high-risk NICU graduates, we describe rates of parent concerns, early intervention access, and developmental delays from the first study visit when infants were 6 months old (adjusted age used if preterm).

Methods: Participants were recruited from a HRIF Clinic, which serves a diverse population of infants who qualified for this program per state criteria (Kuppala et al., 2012). A sample of 35 infants are included in this analysis. Participants were diverse in terms of their race/ethnicity, family income, and medical condition (Table 1). Parent concerns about their child’s development and behavior were reported through a questionnaire in which we asked parents an open-ended question and categorized their responses. We then gathered data on type and dose of any early intervention services. Developmental level was measured using the Vineland Adaptive Behavior Skills, Third Edition (Vineland-3) interview.

Results: At least one concern was reported by parents in over half (66%) of our sample. Motor and medical concerns were the most frequently reported (Table 2). More than half (60%) of participants were receiving at least one early intervention service by their 6-month visit. Nearly half of our sample was receiving physical therapy, with occupational therapy being the second most common intervention (Table 2). The mean Vineland-3 composite score indicated overall developmental abilities within the average range (M=91, SD=12), although there was wide variability in composite scores (SS=73-116; Table 2). Within specific domains, about one-quarter to one-third of infants were identified as having a delay.

Conclusions: A large portion of parents of high-risk NICU graduates reported concerns about their child. Results indicate a slightly higher frequency of concerns in our NICU sample versus a previously reported sample of infants with a family history of autism (66% vs. 57%), with more concerns in our sample falling in the medical and general developmental categories versus speech/language and social in the family history infants (Tran et al., 2021). A relatively high proportion of current participants were enrolled in early intervention services, which speaks to the success of the HRIF Program. Parent concerns and intervention rates went beyond the delays identified using a standardized clinical measure, possibly suggesting that it missed subtler developmental needs. We will continue to recruit and follow infants until they are 24 months, with the expectation that developmental needs will become more apparent in the second year.

Authors

• Salma Yareth Peña, University of California - Los Angeles
  Presenting Author

• Camila Alejandra Ferrario, University of California - Los Angeles

• Sai N Iyer

• Nicole M McDonald, University of California - Los Angeles